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Learning outcomes
At the end of this lecture you will be able to:
Read x-rays systematically
Describe fracture patterns
Interpret healing of fractures
AOTrauma ORP
2013, April
X-ray projection
X-ray projection depends on the thickness of the tissue
that is to be penetrated.
When there is no tissue to penetrate, the color of the
picture will be black.
The greater the depth, the lighter the grey.
Air is projected as black
Soft tissues are grey
Fluids are a lighter grey
Bone is an even lighter grey
Metal is projected as white
Example
AOTrauma ORP
2013, April
AOTrauma ORP
2013, April
Diaphyseal
Metaphyseal
Epiphyseal or intraarticular
AOTrauma ORP
2013, April
4. Wedge fracture
AOTrauma ORP
2013, April
Question 1
Identify the fracture
1. Which bone?
2. Which part of the bone?
3. Which type of fracture?
AOTrauma ORP
2013, April
AOTrauma ORP
2013, April
Question 2
Locate the
fracture?
Articular fractures
Malleoli
Normal aspect of malleoli:
Tibiofibular gap is less than 6 mm.
Joint gap is of equal width.
Joint surfaces are parallel to each other.
Talus is in correct position.
AOTrauma ORP
2013, April
Fractured malleoli
The following x-ray shows a shortened fibula.
The joint gap between the lateral ankle and talus is no
longer parallel.
The fibula is rotated and fractured.
Question 3
Describe this fracture.
1. What about the
joint gap?
2. What about the
fibula?
Knee
Normal aspect of the knee:
AOTrauma ORP
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Question 4
Describe
this
fracture.
Question 5
Describe the fracture.
1. Which bone?
2. Which part of the bone?
3. Which type of fracture?
Question 6
Describe the
fracture.
1. Which bone?
2. Which part of
the bone?
3. Which type of
fracture?
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Question 7
Which bone?
Question 8
x-ray 8 weeks post-op
What do you see here?
What would you tell the
patient?
Question 9
8 months post-op
What do you see here?
What would you tell the
patient?
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Question 10
3 months post-op
What do you see here?
What would you tell the
patient?
Question 11
How old is the
patient?
What is your
diagnosis?
Summary
You should now be able to:
Read x-rays systematically
Describe fracture patterns
Interpret healing of fractures
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Question 2
Question 3
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Question 4
2.
Surgical treatment:
AOTrauma ORP
L-plate 4.5 mm
Cancellous bone screw 6.5 mm (lag screw) and
washer
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Question 5
Question 6
Humeral
Diaphyseal
Spiral
Question 7
Question 8
This x-ray shows an osteosynthesis with plate and screws in a tibial fracture
after 8 weeks.
The fracture is still visible, which is normal after only 8 weeks, without
axial malalignment.
There is minimal callus formation on the lateral side.
There is no screw loosening. The osteosynthesis is stable.
Fracture healing is underway.
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Question 9
Question 10
Question 11
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